Multi-functional medical facility with diagnostic, therapeutic and interventional capabilities

ABSTRACT

A multi-functional medical facility permits emergent diagnostic imaging assessment, image guided therapeutic interventions, and open surgical procedures within the complex. The concept of bringing diagnostic and therapeutic imaging and operative equipment to the critically ill patient or the patient undergoing non-emergency, elective surgery, instead of bringing the patient to the equipment is a major clinical advantage that should improve efficiency, outcome and survival. An important economic advantage is that the components can be used separately and independently of each other, thus enabling them to also be used for routine emergency room (ER) work.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims benefit of U.S. Provisional ApplicationNo. 60/651,323 filed Feb. 9, 2005.

BACKGROUND OF THE INVENTION

1. Field of Invention

The invention relates generally to a multi-functional medical facilitythat includes adjacent rooms set up for imaging patients, such as fordiagnostic imaging and image-guided interventional procedures, and forperforming surgical procedures.

2. Description of Related Art

Hospitals and other medical care facilities typically include separatefacilities for performing patient imaging and administering emergencyservices. Thus, when a critically ill or injured patient is admitted toan emergency room, it is necessary to transfer the patient to adifferent location to perform imaging. For example, the patient can betransferred to computed tomography (CT) and radiographic imaging suitesfor diagnostic studies, or to fluoroscopic and angiographic suites fordiagnostic and image guided interventional procedures, to gaininformation needed before returning the patient to the operating roomfor a surgical procedure. However, the idea of bringing the criticallyill patient to the diagnostic and therapeutic imaging and operativeequipment is disadvantageous in terms of efficiency as well as patientoutcome and survival. For example, oftentimes the patient is too ill tobe moved and, when the patient can be moved, time is wasted, potentiallyresulting in an increase in patient morbidity or mortality. Moreover,additional personnel are needed to move the patient and time isunnecessarily wasted.

BRIEF SUMMARY OF THE INVENTION

The present invention addresses the above and other issues by providinga multi-functional medical facility that includes adjacent rooms set upfor imaging patients, such as for diagnostic imaging and image-guidedinterventional procedures, and for performing surgical procedures

In one aspect, a multi-functional medical facility is provided as adiagnostic and therapeutic emergency room (ER) complex that permitsemergent diagnostic imaging assessment, image guided therapeuticinterventions, and open surgical procedures. The concept of bringingdiagnostic and therapeutic imaging and operative equipment to thecritically ill patient, or the patient undergoing non-emergency,elective surgery, instead of bringing the patient to the equipment,provides a major clinical advantage over current methods that shouldimprove efficiency, outcome and survival. An important economicadvantage is that the components can be used independently for routineER work. Moreover, the cost of the complex can be paid back quicklysince the equipment is used to more efficiently process a greater numberof patients compared to conventional approaches.

In a particular aspect, a multi-functional medical facility is providedthat includes an area equipped to provide emergent diagnostic imagingassessment of a patient, an area equipped to provide image guidedtherapeutic intervention of the patient, and an area equipped to providea surgical procedure of the patient.

The facility can further include a transport mechanism for transportingthe patient to each of the areas, which can be adjacent to one another.The transport can move the same patient table to each area to minimizepatient discomfort.

While a CT scanner is illustrated in the figures as an example only, thearea equipped to provide emergent diagnostic imaging assessment caninclude a CT scanner, MRI scanner, x-ray/angiography device, ultrasounddevice, and/or other imaging device. Similarly, the area equipped toprovide image guided therapeutic intervention of the patient can includea CT scanner, MRI scanner, x-ray/angiography device, ultrasound device,and/or other imaging device. The area equipped to provide a surgicalprocedure of the patient can include a surgical set-up for an emergencyand/or non-emergency, or elective, surgery. Moreover, each of the areascan be operating room-compatible.

The facility can also include at least one shielded, retractable doorarranged to shield radiation from: (a) the area equipped to provideemergent diagnostic imaging assessment, and (b) the area equipped toprovide image guided therapeutic intervention of the patient.

In another aspect, a multi-functional medical facility includes acentral area equipped to provide at least one of emergent diagnosticimaging assessment of a patient, and image guided therapeuticintervention of the patient, and a plurality of areas adjacent to thecentral area that are each equipped to provide a surgical procedure ofthe patient, wherein each of the areas is operating-room compatible.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, benefits and advantages of the presentinvention will become apparent by reference to the following text andfigures, with like reference numbers referring to like structures acrossthe views, wherein:

FIG. 1 illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device;

FIG. 2 a illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device, where a rotatable barrier is in a position forallowing access to the imaging device by two of the operatingrooms/trauma rooms;

FIG. 2 b illustrates a top view of the multi-functional medical facilityof FIG. 2 a, where the rotatable barrier is in a position for allowingaccess to the imaging device by the other two of the operatingrooms/trauma rooms;

FIG. 3 a illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device, where retractable doors are in a position forallowing access to the imaging device by two of the operatingrooms/trauma rooms;

FIG. 3 b illustrates a top view of the multi-functional medical facilityof FIG. 3 a, where the retractable doors are in a position for allowingaccess to the imaging device by the other two of the operatingrooms/trauma rooms.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides a multi-functional medical facility forevaluation and treatment of trauma and critically ill patientspresenting to an emergency room. The facility contains all necessaryequipment to evaluate and treat trauma/critically ill patients. Featuresof this trauma room that different from current conventional roomsinclude a synergistic arrangement of imaging equipment and operatingroom capabilities. Providing both imaging and operative capabilities asdiscussed herein will allow rapid assessment of such patients, whilealso providing image guided diagnostic and therapeutic procedures and/oropen surgical interventions. The facility can eliminate the inherentdelays and risks in transporting a critically ill or injured patient toimaging and operative facilities in different areas of a hospital.Several prototypic configurations are illustrated in the attachedfigures.

FIG. 1 illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device. The operating rooms/trauma rooms can includerooms or areas designated as Room I, Room II, Room III and Room IV.Generally, the rooms or areas can be arranged adjacent or otherwiseproximate to one another. In one possible approach, a central area ofthe facility is equipped to provide emergent diagnostic imagingassessment of a patient, and/or image guided therapeutic intervention ofthe patient, while one or more areas adjacent to the central area areequipped to provide a surgical procedure of the patient.

In the example provided, Rooms I and II are major operating rooms/traumarooms, while Rooms III and IV can be minor trauma rooms or additionalmajor operating rooms/trauma rooms similar to Rooms I and II,respectively. The major operating rooms/trauma rooms are typicallyoutfitted to handle patients such those who have been in an autoaccident, or those who have experienced sudden illnesses such as a heartattack or stroke. The major operating rooms/trauma rooms can beconfigured to meet requirements for operating rooms with an appropriatesurgical set-up, such as by having appropriate air handling andfiltering systems, wash stations, lighting, wall, floor and othersurfaces suitable for cleaning, sterilizing equipment, other medicalequipment, and the like. Generally, any required equipment andfacilities for pre-operative, operative, and post-operative procedurescan be provided. For example, for a major trauma patient, equipment suchas chest tubes, splints and large and small intravenous tubes can beneeded to stabilize the acutely injured patient. Minor trauma rooms aretypically outfitted to handle patients such as those involved in minoraccidents and those experiencing less serious illnesses.

Each room includes a patient table/tabletop on which a patient is held.In one possible approach, the patient table in Room I can be moved froma position A to a position C or position D as indicated such as via aceiling or other overhead track system, using ceiling-mounted arms showndiagrammatically, or other movement mechanism. However, such a mechanismis not required as the patient table can be moved on a wheeled tablesupport or by other means to the different locations. In position C, thepatient can be imaged by an imaging device such as a movable CT gantrythat slides on tracks. When the patient table is moved to position C,the CT gantry can be positioned rightward (as viewed in the figure) toimage the patient such as for a diagnostic assessment. The patient tablecan also be moved to a position D in which an additional imaging device,such as x-ray/angiographic equipment, is used to image the patient suchas for a diagnostic assessment or an image-guided interventionalprocedure. Thus, a patient can be moved on the same patient table froman operating room to an imaging area having one or more imaging devices.Likewise, the patient table can be returned to the position A forfurther procedures in Room I. Similarly, a patient in Room II can bemoved from an associated position B to position C and/or position D whenthe patient from Room I is not using the imaging equipment.

Moreover, when not needed for imaging patients from Rooms I and II, theCT gantry can be moved leftward on the scanner tracks to scan patientsfrom Rooms III and IV, or from other locations, who have more routineinjuries or illnesses.

To block radiation that can be emitted from various medical imagingdevices, folding or other retractable lead shielded doors can beprovided between the area in which the imaging devices are located andthe other areas of the facility. For example, Doors A, B, D and E can beprovided to shield Rooms I, II, III and IV, respectively, from theimaging device. Door C can extend behind the CT gantry to shield anotherpatient on the other side of the gantry. That is, when the gantry ismoved rightward to image a patient, Door C is closed to shield a patienton the left side of the gantry that is being prepared to be imaged. Whenthe imaging is complete, the Door C can be opened and the gantry movedleftward, using appropriate mechanisms. Door C can then be closed toimage the patient on the left side of the gantry while another patientfrom Room I or II is moved to the position C and prepared for imaging.

Thus, in this approach, the facility includes a movable multislice CTgantry that can be shared by adjacent imaging rooms. Additionally, aradiographic and ultrasonic unit with fluoroscopic, angiographic anddigital imaging capabilities can be provided in one or both of theimaging rooms to be shared. Generally, any type of imaging equipment,including a CT scanner, MRI scanner, x-ray/angiography device,ultrasound device, and/or other imaging device, can be used in areas ofthe facility that are equipped to provide emergent diagnostic imagingassessment of a patient, and/or an image guided therapeutic interventionof the patient. Furthermore, each room or area of the facility isoperating room (OR) compatible, indicating, e.g., that the rooms areconfigured to meet requirements for operating rooms, such as by havingappropriate air handling and filtering systems, wall, floor and othersurfaces suitable for cleaning, and the like.

Thus, the patient can be transferred from the operating room to one ormore imaging rooms or areas in the middle of surgery, for instance, toevaluate the effect of the surgery on the patient, and then back to theoperating room to complete the surgery.

Moreover, each piece of equipment can be used together or separately andindependently. Utilizing the equipment together produces a highlysophisticated, synergistic and technologically advanced environment toevaluate critically ill patients that have experienced trauma or otherconditions. When not being utilized together for such purposes, eachpiece of equipment can be used for routine ER diagnostic and therapeuticpurposes since each piece of equipment can be utilized separately andindependently.

In an example use of the facility, a major trauma patient can beadmitted to Room I or II, where procedures are carried out in an attemptto stabilize the patient. The patient can be moved to thex-ray/angiographic equipment in position D to perform an initial scanfrom head to toe to locate broken bones or a collapsed lung, forinstance. The x-ray/angiographic equipment provides a 2-D image of thepatient, and can be used for image-guided interventional procedures,such as inserting chest tubes or intravenous tubes. If a moresophisticated, 3-D image is required, the patient can be positioned toposition C to perform a CT scan, for instance, which allows developmentof an appropriate diagnosis and treatment. The transition from positionD to position C can be achieved by simply rotating the patient table byninety degrees, for instance. Subsequently, a further angiogram can beobtained in position D such as to study a blood vessel or for anotherinterventional therapeutic procedure.

Note that, in each of the embodiments described herein, the operatingrooms, such as Rooms I and II, can be configured for emergency surgeryand/or elective, non-emergency surgery. Thus, a configuration similar towhat is illustrated in FIG. 1 can be provided where imaging equipmentfor assessments and/or interventions is adjacent to or surrounded by oneor more operating rooms in a general-purpose operating suite. Generally,for emergency patients, the imaging equipment is used to determine whatsurgical procedures are needed, while for the non-emergency patients,imaging has previously been performed to determine what electivesurgical procedures are needed. In either case, the imaging equipmentcan be used during the surgery to assess the progress of the surgery.

Thus, in another example use of the facility, a patient undergoingelective, non-emergency surgery can be admitted to Room I or II. Such apatient typically has already undergone imaging to determine that theelective surgery is needed. For instance, a urologist can perform asurgery to remove a kidney stone, or a neurologist can perform a surgeryto close off an aneurysm. In these surgeries, a minimal incision is madein the patient and an appropriate device is inserted into the body toperform the procedure. During the procedure, it can be desirable to usethe imaging equipment in the other areas of the facility to assess theprogress of the surgery, thereby enabling the surgery to proceed morequickly and with greater success. For example, the imaging can allow theneurologist to determine if a clip has been placed properly to close offthe aneurysm. The patient can then be returned to the surgery area tomake the appropriate adjustments as needed.

FIG. 2 a illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device, where a rotatable barrier is in a position forallowing access to the imaging device by two of the operatingrooms/trauma rooms. Rooms I and II can be configured as major operatingrooms/trauma rooms, while Rooms III and IV can be minor trauma rooms oradditional major operating rooms/trauma rooms similar to Rooms I and II.Or, Rooms III and IV can be rooms where patients are prepped forimaging. Or, Room III can be an x-ray/angiography prep room. Doors A andB are retractable shielded doors for shielding Rooms I and II,respectively, from the central area where imaging is performed by a CTgantry, for example, which is movable on tracks. A rotatingx-ray/angiographic C-arm can also be used in the central imaging area.

A rotating CT-angiography complex barrier or wall can be used whichincludes a shielded circular wall with openings having the retractabledoors, Door A and Door B. The barrier separates the central imaging areafrom the surrounding rooms, and is mounted on a mechanism which allowsit to rotate so that the doors are positioned to allow access to thecentral imaging area by either Rooms I and II, or Rooms III and IV. Inthe position shown, patient tables from Rooms I or II can be moved intothe central imaging area. For example, a patient table I can be movedfrom Room I to table position C for CT scanning and/orx-ray/angiographic assessment. Similarly, when the imaging area is notin use, table II can be moved from Room II to table position C for CTscanning and/or x-ray/angiographic assessment.

For example, when table I is moved into the central imaging area, DoorsA and B can be closed to allow imaging to take place. Door A can beopened to move table I back into Room I, after which Door B is openedand table II can be moved into the central imaging area. Doors A and Bcan then be closed to allow imaging to take place again. Door B can thenbe opened to move table II back into Room II. Subsequently, the barriercan be rotated to arrive at the configuration of FIG. 2 b.

FIG. 2 b illustrates a top view of the multi-functional medical facilityof FIG. 2 a, where the rotatable barrier is in a position for allowingaccess to the imaging device by the other two of the operatingrooms/trauma rooms. Here, the CT-angiography complex barrier has rotatedninety degrees counterclockwise. Thus, Doors A and B allow access to thecentral imaging area by table III in Room III, and by table IV in RoomIV, respectively. Moreover, the x-ray/angiographic C-arm can rotate toallow table III to move to table position C via Door A. Alternately,table III can engage the x-ray/angiographic C-arm for continued x-rayevaluation of the ER/major trauma patient. Opposite Room III, Door B canbe opened to allow the CT gantry to be positioned to move into Room IVto image a patient on table IV, e.g., for routine CT scanningFurthermore, Door B can be closed once the CT gantry is moved into RoomIV to allow the x-ray/angiographic C-arm to be used simultaneously andindependently of the CT gantry for any purpose. Door B shields Room IVfrom radiation emitted by the x-ray/angiographic C-arm, while alsoshielding the central imaging area from radiation emitted by the CTgantry, while Door A shields Room III similarly.

FIG. 3 a illustrates a top view of a multi-functional medical facilitythat includes four operating rooms/trauma rooms that share access to amovable imaging device, where retractable doors are in a position forallowing access to the imaging device by two of the operatingrooms/trauma rooms. As before, Rooms I and II can be configured as majoroperating rooms/trauma rooms, while Rooms III and IV can be minor traumarooms or additional major operating rooms/trauma rooms similar to RoomsI and II. Or, Rooms III and IV can be rooms where patients are preppedfor imaging. Or, Room III can be an x-ray/angiography prep room. DoorsA, B, C and D are retractable shielded doors for shielding Rooms I, II,III and IV, respectively, from the central area where imaging isperformed by a CT gantry, for example, which is movable on tracks.

A rotating x-ray/angiographic C-arm can also be used in the centralimaging area. The C-arm can rotate to allow table III to move to tableposition C.

In Room I, patient table I can be moved from Room I to table position Cfor CT scanning and/or x-ray/angiographic assessment. Similarly, whenthe imaging area is not in use, table II can be moved from Room II totable position C for CT scanning and/or x-ray/angiographic assessment.Door C allows table III in Room III to access the central imaging area,while Door D allows table IV in Room IV to access the central imagingarea. In the central area, imaging can be performed by a CT gantry, forexample, which is movable on tracks. A rotating x-ray/angiographic C-armcan also be used in the central imaging area.

For example, when table I is moved into the central imaging area, DoorsA, B, C and D can all be closed to allow imaging to take place. Door Acan be opened to move table I back into Room I, after which Door B isopened and table II can be moved into the central imaging area. Doors Aand B can then be closed to allow imaging to take place again. Door Bcan then be opened to move table II back into Room II, then closedagain. Subsequently, Door C or D can be opened as indicated in theconfiguration of FIG. 3 b.

FIG. 3 b illustrates a top view of the multi-functional medical facilityof FIG. 3 a, where the retractable doors are in a position for allowingaccess to the imaging device by the other two of the operatingrooms/trauma rooms. The x-ray/angiographic C-arm can rotate to allowtable III to move to table position C via Door A. Alternately, table IIIcan engage the x-ray/angiographic C-arm for continued x-ray evaluationof the ER/major trauma patient. Opposite Room III, Door D can be openedto allow the CT gantry to be positioned to move into Room IV to image apatient on table IV, e.g., for routine CT scanning. Furthermore, Door Dcan be closed once the CT gantry is moved into Room IV to allow thex-ray/angiographic C-arm to be used simultaneously and independently ofthe CT gantry for any purpose. As before, Door D shields Room IV fromradiation emitted by the x-ray/angiographic C-arm, while also shieldingthe central imaging area from radiation emitted by the CT gantry, andDoor C similarly shields Room III.

Accordingly, it can be seen that the present invention provides amulti-functional medical facility that permits emergent diagnosticimaging assessment, image guided therapeutic interventions, and surgicalprocedures. The concept of bringing diagnostic and therapeutic imagingand operative equipment to the critically ill patient instead ofbringing the patient to the equipment is a major clinical advantage thatshould improve efficiency, outcome and survival. An important economicadvantage is that the components can be used separately andindependently of each other, thus enabling them to also be used forroutine ER work. Moreover, the invention can be implemented byretrofitting an existing structure, or by providing the appropriatedesign when building a new structure.

The invention has been described herein with reference to particularexemplary embodiments. Certain alterations and modifications may beapparent to those skilled in the art, without departing from the scopeof the invention. The exemplary embodiments are meant to beillustrative, not limiting of the scope of the invention.

1. A multi-functional medical facility, comprising: an area equipped toprovide emergent diagnostic imaging assessment of a patient; an areaequipped to provide image guided therapeutic intervention of thepatient; and an area equipped to provide a surgical procedure of thepatient.
 2. The multi-functional medical facility of claim 1, furthercomprising: a transport mechanism for transporting the patient to eachof the areas.
 3. The multi-functional medical facility of claim 1,wherein: the areas are adjacent to one another.
 4. The multi-functionalmedical facility of claim 1, wherein: the area equipped to provideemergent diagnostic imaging assessment includes a CT scanner, MRIscanner, x-ray/angiography device, ultrasound device, and/or otherimaging device.
 5. The multi-functional medical facility of claim 1,wherein: the area equipped to provide image guided therapeuticintervention of the patient includes a CT scanner, MRI scanner,x-ray/angiography device, ultrasound device, and/or other imagingdevice.
 6. The multi-functional medical facility of claim 1, wherein:the area equipped to provide a surgical procedure of the patientincludes a surgical set-up for an emergency surgery.
 7. Themulti-functional medical facility of claim 1, wherein: the area equippedto provide a surgical procedure of the patient includes a surgicalset-up for a non-emergency surgery.
 8. The multi-functional medicalfacility of claim 1, wherein: each of the areas is operating-roomcompatible.
 9. The multi-functional medical facility of claim 1, furthercomprising: at least one shielded, retractable door arranged to shieldradiation from at least one of: (a) the area equipped to provideemergent diagnostic imaging assessment and (b) the area equipped toprovide image guided therapeutic intervention of the patient.
 10. Amulti-functional medical facility, comprising: a central area equippedto provide at least one of emergent diagnostic imaging assessment of apatient, and image guided therapeutic intervention of the patient; and aplurality of areas adjacent to the central area that are each equippedto provide a surgical procedure of the patient; wherein each of theareas is operating-room compatible.